Health insurance, in plain words

Health insurance pays part of your medical costs in return for a monthly payment, called a premium.

Where people get it. Most people in the US get coverage through a job. Others buy a plan on the ACA marketplace, qualify for Medicaid or CHIP because of income, or have Medicare at 65 or with some disabilities.

What you pay. You pay the premium each month. When you use care, you pay up to your deductible first, then a copay or coinsurance, until you reach the out-of-pocket maximum for the year.

When you can sign up. Marketplace plans open once a year, at open enrollment. A life event such as losing coverage, moving or having a baby can open a special enrollment period. Medicaid takes applications all year.

Help paying. A premium tax credit can lower a marketplace plan’s monthly cost, depending on household income. Medicaid rules differ by state.